Medical apparatus for injection, insufflation, and the like



NOV. 20, 1956 DE MQNTAUGE 2,771,072

MEDICAL APPARATUS FOR INJECTION, INSUFFLATION, AND THE LIKE Filed Dec. 24, 1952 United States Patent Q MEDICAL APPARATUS FOR INJECTION, INSUFFLATION, AND THE LIKE Jacques Antoine de Montaug, Paris, France Application December 24, 1952, Serial No. 327,733 Claims priority, application France December 26, 1951 1 Claim. (Cl. 128-241) This invention relates to medical apparatus for the injection and insufilation or spraying of therapeutic media used for internal treatment, and similar purposes.

The usual means employed for injection and insufilation is a nozzle, cannula or probe, i. e. a tapered tubular part providing a conduit which is inserted in a suitable position into the body of the patient, and through which the desired agent is delivered either in a predetermined measured quantity, or in excess and under pressure.

It is an object of the invention to provide a medical apparatus for the uses specified which comprises two separate conduits adapted to be separately connected to an injection source and to a source of vacuum.

The invention makes it possible at the same time as the treating agent is injected towards or into an organ, to draw out any organic secretions or waste products from that organ or an adjacent organ. This eliminates the loss of agent whichis unavoidable if an ordinary cannula or the like is used for alternate injection and suction through a common conduit.

By providing an appropriate relative position between the orifices of the two conduits of the apparatus, respectively serving for injection and suction, it further becomes possible to avoid interference with the injection process of any secretions and waste which may be present at the orifice of the injection conduit, such secretions and waste being discharged as a result of the suction exerted through the suction conduit.

Another object of the invention is to isolate the organ being treated. For this purpose according to the invention the suction conduit is made to open around the injection conduit into an element suitably conformed so as to engage sealingly about a part of the body surrounding said organ. As a result of the suction, the said element will then be applied against said part and it becomes possible owing to the sealing engagement obtained to perform a pressure injection through the injection conduit under improved conditions and without any loss of treating agent.

A particularly useful application contemplated according to the invention relates to tubal insufflation and hysterography, practices that have assumed an extensive development in present-day gynecological therapy. When employing the methods of test in use heretofore, the practitioner in order to insert a cannula into the uterine cavity, has to grip the lateral part of the uterine cervix with a forceps or tweezers. The mere fact of this gripping of the cervix throughout the test inflicts prolonged pain and the necessity of imparting tension with the tweezers and pressure with the probe adds to the painful characteristics of the test and may even result in a haemorrhage.

When used for a similar purpose, a cannula comprising a device according to the invention and wherein the inner element is adapted to serve as an injection tube, the outer element terminates, short of the tip of the cannula, in a cup-shaped portion adapted to conform with the surface of the cervix. The cup is preferably made of transparent material to enable the practitioner to observe t-herethrough the insertion of the injection tube.

In a preferred form of embodiment, the hysterographic cannula comprises a cylindrical body supporting the cup at the end thereof and connected with a suction line through an obliquely directed lateral connection, while the injection tube is secured in the end of the cylindrical body carrying an external adaptor for connection with the injection pressure line, and passes freely through said body to project beyond the cup.

The invention will now be described with reference to the accompanying drawings wherein:

Figure 1 is a longitudinal section through a cannula provided with two separate flow lines according to the invention;

Figure 2 is a similar view of another embodiment of the invention more particularly adapted for hysterographic operations;

Figure 3 shows a cannula similar to that in Fig. 2 in place for a treatment, and

Figure 4 is a similar view of a modified form of the cannula.

The cannula shown in Fig. 1 comprises a cylindrical body 1 having an end portion formed with a restriction 2 followed by a rounded portion 3 to enable insertion thereof in sealed engagement with a flexible hose. The end 4 of the body 1 is tapered towards its terminal orifice 5 in the general form of a truncated paraboloid of revolution to facilitate insertion.

A tube 6 is fitted coaxially within the body of cannula 1 and its end 7 tapers towards a terminal orifice 8 pro jecting beyond the end of the body. The diameter of tube 6 at the point where it passes through aperture 5 is smaller than the diameter of said aperture, so as to define a flow passage out of the body of cannula 1. The tube 6 within the cannula body element 1 forms an elbow 9 and passes out of the cannula through a side thereof, being welded thereto, and the projecting part of the tube terminates in a rounded portion 10 for sealing insertion thereof into a flexible pipe.

Thus it is seen that the cannula is provided with two separate flow lines with separate outlet orifices and separate inlet connections. One line is for connection with a source of the therapeutic agent and serves as an injection or insufllation line, while the other may be connected with a suction source or pump.

Accordingly, two types of operation can be contemplated depending on which one of the flow lines is used for the injection or insufilation.

The cannula according to the invention can be used for aerosol treating the orifice of any recessed internal organ. The inner tube 6 is connected with a suction source and the cannula body 1 is connected with an aerosol generator. The cannula is positioned so that the end of the inner tube 6 is inserted into the meatus of the organ undergoing treatment, while the element 1 opens at a point facing the latter. The meatus is cleaned out by drawing out any secretions and mucosity accumulated in it, and the orifice 6 remains free to provide a passage for the aerosols throughout the treatment. The treatment affects exclusively the orifice of the organ.

Conversely, the same cannula may serve to perform an injection into an organ by connecting the inner tube 6 with the source of therapeutic agent and the body 1 of cannula with the suction source. The treatment will then involve the cavity of the organ itself, while the secretions and mucosity therein are eliminated from a point near the orifice of the organ.

The form of embodiment of the invention shown in Fig. 2 is more particularly intended for the procedure just mentioned, in the particular instance where the cavity to be treated is the uterine cavity. This embodiment only differs from that previously described in that the body 1' instead of having a restricted end portion 4 as in Fig. .1, is' flared in the formi of a cup. This flared cup portion may be formed as a separate part affixed to the end of the cannula body. For this purpose the body 1 may be made to terminate with a flared section 11 adapted to receive therein a frnstoconical flange 12 integral with the end of the cup member 13 shaped in conformity with the uterine cervix 14- (Fig. 3), and adapted to be applied there against forcibly under the action of the suction generated within the cannula body through its connection with the suction source or pump. The injection or insufllationas the case may bewill be performed through the inner tube 6 whichserves the function of a probe and which is inserted into the cervical orifice 15.

Preferably, the cup member is transparent to facilitate the practitioners task in presenting the instrument to the cervix and inserting the probe into the cervical orifice. The part constituting the cup member may be made of glass whereas the remainder of the cannula may be made of stainless steel. Vacuum is applied gradually as the cannula is inserted and as the cup member thereupon conforms to the surface of the cervix. The latter molds itself to the inner surface of the cup about the probe and isolates the orifice of the uterine cervix in a sealing manner, thereby averting the diflicult and painful placing of cervical tweezers. The requisite injection or insufl lation can then be performed under pressure.

Hysterography and tubal insufilation can then be performed without incurring the risk of traumatism or haemorrhage and under painless conditions. Moreover, the use of a cannula provided with a transparent terminal cup element makes it possible to take a perfectly clear X-ray picture, since the cervix is not concealed by the presence of opaque instrument.

Alternatively, the cup member can be provided integral with the cannula body and in this case, in order to ensure that the cup is transparent, the cannula is preferably made entirely from glass or transparent plastic material. Fig. 4 shows by way of example a modified form of such a cannula in a preferred embodiment.

The cannula body 16 is sealed within a closed end member 17 formed with an obliquely extending connector 18 adapted to have a flexible hose connected with it from a suction pump, and communicating therewith through a chamber 19. The inner tube 20 coaxial with the body asfar as its rearmost end traverses the chamber 19 and is received in an axial boss of the end member, from which extends a connector 21 communicating with said inner tube, and adapted to connect with a flexible pipe from a source of the agent to be injected or insufllated.

At the foremost end the cannula body is deflected at a flattened angle and thereafter flares into the cup portion- 22 having-its end surrounded with an external bead 23. The inner tube conforms with the curvature and terminates in a thickened portion 24 and is thereafter extended by a conical probe 25 having a rounded end. The thickened part24 is secured by means of a few spot welds 26 with the side wall of the body near the rear end of cup portion. Since the cannula, including the body and the inner tube, except the end portion thereof are made of glass or transparent plastic, there is no opaque obstacle to interfere with the making of a full and clear X-ray picture of the uterine cervix.

The last described form of embodiment has shown itself to provide maximum convenience in practice. The

thickened part 24 serves to limit the insertion of the probe into the cervical duct to a point corresponding to a satisfactory insertion of the uterine cervix into the cup memher to allow it to become closely applied against the inner surface of the cup under the effect of suction.

It will be understood that other uses may be conceived for the invention and suitably' modified forms of the parts may then be made in accordance with the contemplated use. In particular, a cannula having two separate flow lines according to the invention may be used for oral insufilation. The cannula body would then be made to connect with a mask applied over the face of the patient, While the probe would then be suitably conformed for insertion into the mouth. The suction produced in the mask by the cannula body will apply the mask into sealing engagement with the face, thus isolating the mouth from the external atmosphere.

The above method may be used for anti-tuberci1lar vaccination by means of pulmonary aerosols. The respective suction and insufilation lines would then be coritrolled by means of a reversing switch or the like in such a way that a very slight suction will be maintained within the body of the apparatus during the discharge of B. C. G. aerosols or the like, and a higher suction would be produced immediately upon termination of the aerosol discharge, in order completely to drain the insufflation line. The operator performing the treatment will not, in this way, incur the risk of breathing in B. C. G. gas on removal of the mask from the patients face following the treatment.

What I claim is:

An injection and insufllation cannula comprising in combination, an outer tube of a transparent material having a deflected end portion flared in the form of a cup element conforming with the shape of the uterine cervix, an inner tube of a transparent material extending through said outer tube coaxially therewith and formed with a thickened portion within the cup element and a taper projecting beyond said element, said thickened portion of the tube being welded to the wall of the cup element adjacent the inner end of said element, a sealed end piece secured to the opposite end of the outer tube and providing with an angularly extending connector communicating with said tube, an axial boss on said end piece, having a hole adapted to receive the opposite end of the inner tube, a connector on said boss communicating with the tube, and means for sealing 'said tubes in said end piece, the outer tube being adapted for connection with a suction line, and the inner tube adapted for connection with an injection line.

References Cited in the file of this patent UNITED STATES PATENTS 559,417 Spencer May 5, 1896 633,557 Akers Sept. 26, 1899 811,111 Wegefartn Jan. 30, 1906 942,015 Short Nov. 30, 1909 989,839 Fowler Apr. 18, 1911 FOREIGN PATENTS 483,807 France May 18, 1917 

